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Assessing Localized Skin-to-Fat Water in Arms of Women with Breast Cancer Via Tissue Dielectric Constant Measurements in Pre- and Post-surgery Patients

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Skin-to-fat tissue dielectric constant (TDC) values at 300 MHz largely depend on tissue water and provide a rapid way to assess skin water by touching skin with a probe for approximately 10 s. This method has been used to investigate lymphedema features accompanying breast cancer (BC), but relationships between TDC and nodes removed or symptoms is unclear. Our goals were: (1) to compare TDC values in BC patients prior to surgery (group A) and in patients who had BC-related surgery (group B) to determine if TDC of group B were related to nodes removed and reported symptoms and (2) to develop tentative lymphedema-detection thresholds.

Methods

Arm volumes and TDC values of at-risk and contralateral forearms and biceps were determined in 103 women awaiting surgery for BC and 104 women who had BC-related surgery 26.3 ± 17.5 months prior to evaluation. Inter-arm ratios (at-risk/contralateral) were determined and patients answered questions about lymphedema-related symptoms.

Results

Inter-arm TDC ratios for group A forearm and biceps were respectively 1.003 ± 0.096 and 1.012 ± 0.143. Group B forearm ratios were significantly greater, and among group B patients who reported at least one symptom there was a significant correlation between TDC ratios and symptom burden and nodes removed.

Conclusions

Inter-arm TDC ratios are significantly related to symptoms and nodes removed. Ratios increase with increasing symptom score and might be used to detect pre-clinical unilateral lymphedema using TDC ratio thresholds of 1.30 for forearm and 1.45 for biceps. Threshold confirmation awaits targeted prospective studies but can serve as guideposts to provide quantitative and easily done tracking assessments during follow-up visits.

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References

  1. Alanen E, Lahtinen T, Nuutinen J. Variational formulation of open-ended coaxial line in contact with layered biological medium. IEEE Trans Biomed Eng. 1998;45(10):1241–8.

    Article  CAS  PubMed  Google Scholar 

  2. Nuutinen J, Ikaheimo R, Lahtinen T. Validation of a new dielectric device to assess changes of tissue water in skin and subcutaneous fat. Physiol Meas. 2004;25(2):447–54.

    Article  CAS  PubMed  Google Scholar 

  3. Stuchly MA, Athey TW, Stuchly SS, Samaras GM, Taylor G. Dielectric properties of animal tissues in vivo at frequencies 10 MHz–1 GHz. Bioelectromagnetics. 1981;2(2):93–103.

    Article  CAS  PubMed  Google Scholar 

  4. Mayrovitz HN, Luis M: Spatial variations in forearm skin tissue dielectric constant. Skin Res Technol. 2010;16(4):438–43.

    Article  PubMed  Google Scholar 

  5. Mayrovitz HN, Bernal M, Carson S. Gender differences in facial skin dielectric constant measured at 300 MHz. Skin Res Technol. 2012;18:504–10.

    Article  PubMed  Google Scholar 

  6. Mayrovitz HN, Bernal M, Brlit F, Desfor R. Biophysical measures of skin tissue water: variations within and among anatomical sites and correlations between measures. Skin Res Technol. 2013;19(1):47–54.

  7. Mayrovitz HN, McClymont A, Pandya N. Skin tissue water assessed via tissue dielectric constant measurements in persons with and without diabetes mellitus. Diabetes Technol Ther. 2013;15(1):60–5.

    Article  PubMed  Google Scholar 

  8. Mayrovitz HN, Brown-Cross D, Washington Z. Skin tissue water and laser Doppler blood flow during a menstrual cycle. Clin Physiol Funct Imaging. 2007;27(1):54–9.

    Article  PubMed  Google Scholar 

  9. Birkballe S, Jensen MR, Noerregaard S, Gottrup F, Karlsmark T. Can tissue dielectric constant measurement aid in differentiating lymphoedema from lipoedema in women with swollen legs? Br J Dermatol. 2014;170(1):96–102.

    Article  CAS  PubMed  Google Scholar 

  10. Jensen MR, Birkballe S, Nørregaard S, Karlsmark T. Validity and interobserver agreement of lower extremity local tissue water measurements in healthy women using tissue dielectric constant. Clin Physiol Funct Imaging. 2012;32(4):317–22.

    Article  PubMed  Google Scholar 

  11. Nixon J, Purcell A, Fleming J, McCann A, Porceddu S. Pilot study of an assessment tool for measuring head and neck lymphoedema. Br J Community Nurs. 2014;19(Sup4):S6–S11.

    Article  Google Scholar 

  12. Mayrovitz HN. Assessing local tissue edema in postmastectomy lymphedema. Lymphology. 2007;40(2):87–94.

    CAS  PubMed  Google Scholar 

  13. Mayrovitz HN, Davey S, Shapiro E. Localized tissue water changes accompanying one manual lymphatic drainage (MLD) therapy session assessed by changes in tissue dielectric constant in patients with lower extremity lymphedema. Lymphology. 2008;41(2):87–92.

    CAS  PubMed  Google Scholar 

  14. Mayrovitz HN, Davey S. Changes in tissue water and indentation resistance of lymphedematous limbs accompanying low level laser therapy (LLLT) of fibrotic skin. Lymphology. 2011;44(4):168–77.

    CAS  PubMed  Google Scholar 

  15. Fife CE, Davey S, Maus EA, Guilliod R, Mayrovitz HN. A randomized controlled trial comparing two types of pneumatic compression for breast cancer-related lymphedema treatment in the home. Support Care Cancer. 2012;20:3279–86.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Mayrovitz HN. Local tissue water assessed by measuring forearm skin dielectric constant: dependence on measurement depth, age and body mass index. Skin Res Technol. 2010;16(1):16–22.

    Article  PubMed  Google Scholar 

  17. Mayrovitz HN, Weingrad DN, Davey S. Local tissue water in at-risk and contralateral forearms of women with and without breast cancer treatment-related lymphedema. Lymphat Res Biol. 2009;7(3):153–8.

    Article  PubMed  Google Scholar 

  18. Aimoto A, Matsumoto T. Noninvasive method for measuring the electrical properties of deep tissues using an open-ended coaxial probe. Med Eng Phys. 1996;18(8):641–6.

    Article  CAS  PubMed  Google Scholar 

  19. Alanen E, Lahtinen T, Nuutinen J. Penetration of electromagnetic fields of an open-ended coaxial probe between 1 MHz and 1 GHz in dielectric skin measurements. Phys Med Biol. 1999;44(7):N169–76.

    Article  CAS  PubMed  Google Scholar 

  20. Nuutinen J, Lahtinen T, Turunen M, et al. A dielectric method for measuring early and late reactions in irradiated human skin. Radiother Oncol. 1998;47(3):249–54.

    Article  CAS  PubMed  Google Scholar 

  21. Casley-Smith JR. Measuring and representing peripheral oedema and its alterations. Lymphology. 1994;27(2):56–70.

    CAS  PubMed  Google Scholar 

  22. Mayrovitz HN. Limb volume estimates based on limb elliptical vs. circular cross section models. Lymphology. 2003;36(3):140–3.

    CAS  PubMed  Google Scholar 

  23. Karges JR, Mark BE, Stikeleather SJ, Worrell TW. Concurrent validity of upper-extremity volume estimates: comparison of calculated volume derived from girth measurements and water displacement volume. Phys Ther. 2003;83(2):134–45.

    PubMed  Google Scholar 

  24. Mayrovitz HN, Sims N, Macdonald J. Assessment of limb volume by manual and automated methods in patients with limb edema or lymphedema. Adv Skin Wound Care. 2000;13(6):272–6.

    CAS  PubMed  Google Scholar 

  25. Meijer RS, Rietman JS, Geertzen JH, Bosmans JC, Dijkstra PU. Validity and intra- and interobserver reliability of an indirect volume measurements in patients with upper extremity lymphedema. Lymphology. 2004;37(3):127–33.

    CAS  PubMed  Google Scholar 

  26. Sander AP, Hajer NM, Hemenway K, Miller AC. Upper-extremity volume measurements in women with lymphedema: a comparison of measurements obtained via water displacement with geometrically determined volume. Phys Ther. 2002;82(12):1201–12.

    PubMed  Google Scholar 

  27. Sitzia J. Volume measurement in lymphoedema treatment: examination of formulae. Eur J Cancer Care (Engl). 1995;4(1):11–6.

    Article  CAS  Google Scholar 

  28. Armer JM, Radina ME, Porock D, Culbertson SD. Predicting breast cancer-related lymphedema using self-reported symptoms. Nurs Res. 2003;52(6):370–9.

    Article  PubMed  Google Scholar 

  29. Ward LC, Dylke E, Czerniec S, Isenring E, Kilbreath SL. Reference ranges for assessment of unilateral lymphedema in legs by bioelectrical impedance spectroscopy. Lymphat Res Biol. 2011;9(1):43–6.

    Article  CAS  PubMed  Google Scholar 

  30. Ward LC, Dylke E, Czerniec S, Isenring E, Kilbreath SL. Confirmation of the reference impedance ratios used for assessment of breast cancer-related lymphedema by bioelectrical impedance spectroscopy. Lymphat Res Biol. 2011;9(1):47–51.

    Article  CAS  PubMed  Google Scholar 

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Conflict of interest

No author has any commercial interest in the subject of this study

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Authors and Affiliations

  1. College of Medical Sciences, Nova Southeastern University, Davie, FL, USA

    Harvey N. Mayrovitz PhD

  2. Cancer HealthCare Associates, Aventura, FL, USA

    Daniel N. Weingrad MD & Lidice Lopez PA

Authors
  1. Harvey N. Mayrovitz PhD
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  2. Daniel N. Weingrad MD
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  3. Lidice Lopez PA
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Correspondence to Harvey N. Mayrovitz PhD.

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Mayrovitz, H.N., Weingrad, D.N. & Lopez, L. Assessing Localized Skin-to-Fat Water in Arms of Women with Breast Cancer Via Tissue Dielectric Constant Measurements in Pre- and Post-surgery Patients. Ann Surg Oncol 22, 1483–1489 (2015). https://doi.org/10.1245/s10434-014-4185-5

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  • DOI: https://doi.org/10.1245/s10434-014-4185-5

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